title: Pre-pregnancy weight and excess weight gain are risk factors for macrosomia in women with gestational diabetes.
abstract: OBJECTIVE
  To determine whether women with gestational diabetes mellitus (GDM) whose weight gain exceeded the 2009 Institute of Medicine (IOM) recommendations were more likely to have macrosomia.
  
  
  METHODS
  Retrospective cohort study of the association of weight gain in women with Class A1 GDM, with term (≥37 weeks) singleton liveborns and macrosomia (birthweight ≥4000 g). Multivariate logistic regression models were used to adjust for covariates and test for interactions.
  
  
  RESULTS
  Of 1502 women studied, pre-pregnancy body mass index (BMI) categories were: normal (39.6%), overweight (28.5%) and obese (31.9%). The mean (±standard deviation ) weight gain (lbs) for these groups was: 27.6±10.9, 24.2±13.0 and 18.8±16.3 (P<0.0001), whereas the occurrence of macrosomia was 7.4, 11.4 and 19.0%, respectively. Women with an obese BMI were twice as likely to have a macrosomic infant compared with women in the normal BMI group (odds ratio, OR 2.0; 95% CI 1.4-3.0; P=0.0005). Independently, women who exceeded the IOM guidelines were three times more likely to have a macrosomic infant (OR 3.0, 95% CI 2.2-4.2, P<0.0001).
  
  
  CONCLUSIONS
  Maternal pre-pregnancy weight and weight gain during pregnancy appear to be significant and independent risk factors for macrosomia in women with GDM.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. jouzouni@usc.edu
authors.forename: J G
authors.initials: JG
authors.lastname: Ouzounian
authors.forename: G D
authors.initials: GD
authors.lastname: Hernandez
authors.forename: L M
authors.initials: LM
authors.lastname: Korst
authors.forename: M M
authors.initials: MM
authors.lastname: Montoro
authors.forename: L R
authors.initials: LR
authors.lastname: Battista
authors.forename: C L
authors.initials: CL
authors.lastname: Walden
authors.forename: R H
authors.initials: RH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001835:Body Weight; D048909:Diabetes Complications; D016640:Diabetes, Gestational; D005260:Female; D005320:Fetal Macrosomia / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D012307:Risk Factors; D015430:Weight Gain